— 心理社會完整性 · MEDIUM · SATA —
護理師為有「日落症候群」徵兆的失智症患者制定照護計畫，應包含哪些內容？（選所有適合的）
A nurse is creating a plan of care for a client with dementia who has started to exhibit signs of 'sundowning'. Which interventions should the nurse include? (Select all that apply.)
- AMaintain a consistent daily routine✓ 正解維持一致的每日作息
- BIncrease environmental stimulation in the evening增加傍晚時段的環境刺激
- CLimit daytime napping✓ 正解限制白天午睡
- DKeep the environment well-lit during the evening✓ 正解傍晚時段保持環境明亮
- EProvide familiar items in the room✓ 正解在房間內提供熟悉的物品
— Explanation · 中文詳解 —
日落症候群與生理時鐘混亂有關。照護重點為調整日夜節律，如減少日間午睡以增加夜間睡眠需求；維持固定的作息可給予安全感；夜間保持適當燈光可減少因光線不足造成的幻覺與混亂。增加刺激會導致認知負擔加重，故選項 B 錯誤。
Interventions for sundowning focus on reducing confusion and maintaining a regular circadian rhythm. Maintaining a consistent routine, limiting daytime naps, providing adequate evening lighting, and offering familiar items help decrease anxiety and disorientation. Increasing environmental stimulation in the evening should be avoided as it can exacerbate agitation.
✦ 台美臨床差異
美國長照中心強調非藥物治療的環境設計；台灣受限於人力與病房空間，常仰賴藥物控制，未來需加強非藥物介入的衛教。